HIV in Malawi

HIV in Malawi affects the population a great deal. In 2011 it was estimated 910,000 people of the 1.5 million people living in Malawi were living with HIV (“HIV & AIDS in Malawi”). AIDS is the leading cause of death in adults and a factor in the countries low life expectancy. The first AIDS case was reported in 1985, but little was done to really fight the problem. In 1989 a five year plan was announced, but it wasn’t until 2000 and 2004 that programs fighting HIV and AIDS really started to intensify in Malawi. International donors provide a great deal of HIV/AIDS prevention and treatment funding. These programs include, The World Bank, The Global Fund, The World Health Organizations , UNAIDS, and The President’s Emergency Plan For AIDS Relief. “Heterosexual sex accounts for the majority of HIV infections in Malawi” and “HIV prevention efforts are largely focused on preventing sexual transmission of HIV, due to the majority of HIV infections that occur though this route” (“HIV & AIDS in Malawi”). Structural issues, such as stigma, discrimination, lack of resources, etc. impede prevention from occurring on a greater scale.
The article I chose focused on the HIV-related stigmatization and how that decreases the likelihood of treatment and support. The study conducted “examined experiences of interpersonal discrimination, internalized stigma, and discrimination at health care facilities among HIV-positive adults” (Neuman). This article found that women were more likely to experience discrimination than men. The study was conducted in four different countries and in Malawi it was found that among married women, infection because of a husband’s infidelity was seen to be common. There was no discrimination found in internalized stigma or discrimination in health care facilities. What was interesting near the end of the article is that there was mixed associations between care and support and the forms of discrimination. Those experiencing internalized stigma were less likely to join a support group, while those experiencing interpersonal discrimination seemed to use utilize support groups.

“HIV & AIDS in Malawi,” AVERT, accessed 8 August, 2014. http://www.avert.org/hiv-aids-malawi.htm

Neuman, Melissa, Obermeyer, Carla Makhlouf, “Experiences of stigma, discrimination, care and support among people living with HIV: A four country study,” Accessed 8 August 2014, doi: 10.1007/s10461-013-0432-1.

Link: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3671197/

This Post Has 2 Comments

  1. Adam Feuerstein says:

    Breanna, your article looks very interesting and draws from multiple aspects of anthropological approaches. The first and most prominent way this journal is written is from an applied approach. The article examines experiences of interpersonal discrimination, stigma, and discrimination. The use of interviews and information directly from the public allows for the scientists conducting the research to personally see how those people are affected from the patient’s mindset. The cultural setting is very different than that of America, so it was important for those collecting the data to not make assumptions but to understand the culture and find the real cause behind the massive percentage of HIV positive people. An experimental approach was also used because this aspect looks at the way people perceive their own illness. For many of the people in Malawi they do not want to be seen as someone who suffers from the illness so they ignore the problem. The ignorance of the problem only leads to an increase in its prevalence among the Malawi population. Anthropologists are particularly good at not just identifying an illness that a person has due to their cultural setting, but also how they perceive themselves and the illness; leading to if and how they receive help. I think a lot still needs to be done in this area of the globe to contain HIV and slowly diminish the occurrences but this will take a lot of work by anthropologist working with people to let them know how they can best move forward. The work of anthropologist to identify some of the underlying problems is just the beginning of the correction process.

  2. Pamela Perez says:

    The anthropologists you chose for this week’s assignment and their study is a perfect example of an anthropologist that incorporated almost every kind of anthropological approach we have learned about so far. Her study focuses mainly on the discriminatory aspect of HIV in Malawi. Compared to a lot of other studies on the same issue, this is one of the first that targets the human level of HIV, not just the medical side of it. Cultural, societal, and individual stigmas are just as strong as the actual ailment, and understanding how to help cope with that, allows one to help treat HIV more adequately in my opinion. The clinical approach was definitely a part of this research because it emphasis the idea that one needs to consider non-medical factors when trying to treat a condition that is widespread within a certain cultural population. As described in the journal you chose, the persistent stigmas that are being thrown at both male and females with HIV is significantly hindering the effectiveness of any preventative solutions.

    Applying anthropology is an incredibly important contribution to understanding this health problem because one would think that African men and female just don’t want to get help or that they just aren’t educated enough to know the implications of HIV on their lives. This isn’t the case. They are being looked down upon within their own cultures and because it’s so prevalent amongst them, its hard to show them that it’s not a curse, but an unfortunate circumstance-especially for the young women who are raped or abused. A major part of the research that I agreed with, is where it reads:

    “…analysis suggests that…experiencing different forms of this constructs may affect access to social support and health care. Internalized stigma, in particular, appears to be inversely associated with both status disclosure and utilization of support groups…respondents experiences internalized stigma may…consequently experience difficulty coping with HIV”

    I see anthropologists as the necessary ethnomedical ‘tools’ almost. Like, when you have a car and you don’t understand the importance that the seating arrangement has on the construct of the car, or how it runs. Or when you change the engine without fully knowing how the other one worked better, because you just wanted to get a better engine. I don’t know if that makes any sense, it probably doesn’t, but the point I’m trying to make is that anthropologists are the key to a lot of the relief efforts that aim to rid areas where certain predominant diseases, like HIV, are a major problem. Your article selection was awesome!

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